Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Pulmonology
Volume 2016 (2016), Article ID 3257084, 4 pages
http://dx.doi.org/10.1155/2016/3257084
Case Report

Extracorporeal Lung Support as a Bridge to Diagnosis of Pulmonary Tumor Embolism

1Department of Surgery, University of Alberta, Edmonton, AB, Canada
2Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
3Department of Medicine, University of Alberta, Edmonton, AB, Canada
4University of Alberta Hospital, Edmonton, AB, Canada

Received 2 October 2016; Accepted 24 November 2016

Academic Editor: Samer Al-Saad

Copyright © 2016 Vishnu Vasanthan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bridging to diagnosis is an emerging technique used in end-stage cardiorespiratory failure that prolongs a patient’s life using various modalities of extracorporeal lung support (ECLS) to achieve antemortem diagnosis. Pulmonary tumor embolism occurs when cell clusters travel from primary malignancies through venous circulation to the lungs, causing respiratory failure through inflammatory and venoocclusive pathways. Due to its nonspecific symptomatology, pulmonary tumor embolism remains an elusive diagnosis antemortem. Herein, we bridge a patient who presented in acute respiratory failure to the diagnosis of pulmonary tumor embolism from a gastric signet-ring cell carcinoma using ECLS modalities including venoarterial extracorporeal membrane oxygenation and centrally cannulated Novalung pumpless extracorporeal lung assist. We demonstrate the utility of this approach in diagnostically uncertain cases in unstable patients who are potentially acceptable ECLS and transplant candidates.